Boundary-Spanning Care: Reducing Psychiatric Rehospitalization and Self-Injury in a Jail Population

Abstract

Individuals with serious mental illness detained in jail may require frequent psychiatric hospitalization due to the destabilizing nature of the jail environment. This study examined the impact of a pilot treatment program involving continuity of patient care across jail and hospital settings aimed at reducing hospitalizations and negative health outcomes for a population of high-risk, incarcerated individuals with mental illness. This study examined rate ratios of psychiatric hospitalizations, injuries, and suicide watches, comparing 15 patients in the treatment program to themselves pretreatment and to a control group of 15 frequently rehospitalized patients. Patients in treatment experienced significant decreases in overall hospitalizations ( p < .001), 15-day rehospitalizations ( p < .002), and suicide watches in jail ( p < .02), compared to themselves pretreatment. A boundary-spanning treatment program lowered hospitalization rates and need for suicide watch for a small, yet clinically complicated and challenging group of patients.

Preventing suicidal and self-Injurious behavior in correctional facilities: A systematic literature review and meta-analysis

“…Ten studies evaluated the efficacy of psychotherapy. 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 Six studies analyzed comprehensive multicomponent suicide prevention strategies. 6 , 32 , 43 , 44 , 45 , 46 Two studies reported on the efficacy of peer support schemes.…”

“…Several studies reported various issues related to conducting an evaluation study in prison settings. 33 , 36 , 38 , 44 , 47 These issues included the frequent and unpredictable transfer or release of prisoners that can increase the rate of attrition. 33 Furthermore, the nature of correctional facilities can prevent researchers from carrying out randomization.…”

Rapport and Relationship Building in a Therapeutic Community: Examining the Dynamic Between Correctional Officers and Incarcerated Persons

“…Research suggests that COs can play an active role in the promotion of rehabilitative goals by providing encouragement and positive support and assisting in the procurement of resources and services (Schaefer, 2018; Tait, 2011). In the American criminal justice system, duties that were traditionally assigned to various correctional staff are slowly blending to other positions as ideas about the effectiveness of prison programming are changing and the need for boundary spanning 1 has become imminent in jail-to-community initiatives (Bratina, 2017; Bursac et al, 2018; Manchak et al, 2014; Rao et al, 2016).…”

“… 1. Referring to a process whereby individuals who have experience working in multiple systems of care have the ability and expertise to provide cross-systems perspectives and/or multidisciplinary problem-solving strategies (Bratina, 2017; Bursac et al, 2018). …”